van Santwijk Lusien, Kouwenberg Valentina, Meijer Frederick, Smits Marion, Henssen Dylan
Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 EZ, Nijmegen, The Netherlands.
Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights Imaging. 2022 Jun 7;13(1):102. doi: 10.1186/s13244-022-01230-7.
Molecular characterization plays a crucial role in glioma classification which impacts treatment strategy and patient outcome. Dynamic susceptibility contrast (DSC) and dynamic contrast enhanced (DCE) perfusion imaging have been suggested as methods to help characterize glioma in a non-invasive fashion. This study set out to review and meta-analyze the evidence on the accuracy of DSC and/or DCE perfusion MRI in predicting IDH genotype and 1p/19q integrity status.
After systematic literature search on Medline, EMBASE, Web of Science and the Cochrane Library, a qualitative meta-synthesis and quantitative meta-analysis were conducted. Meta-analysis was carried out on aggregated AUC data for different perfusion metrics.
Of 680 papers, twelve were included for the qualitative meta-synthesis, totaling 1384 patients. It was observed that CBV, ktrans, Ve and Vp values were, in general, significantly higher in IDH wildtype compared to IDH mutated glioma. Meta-analysis comprising of five papers (totaling 316 patients) showed that the AUC of CBV, ktrans, Ve and Vp were 0.85 (95%-CI 0.75-0.93), 0.81 (95%-CI 0.74-0.89), 0.84 (95%-CI 0.71-0.97) and 0.76 (95%-CI 0.61-0.90), respectively. No conclusive data on the prediction of 1p/19q integrity was available from these studies.
Future research should aim to predict 1p/19q integrity based on perfusion MRI data. Additionally, correlations with other clinically relevant outcomes should be further investigated, including patient stratification for treatment and overall survival.
分子特征在胶质瘤分类中起着关键作用，这会影响治疗策略和患者预后。动态磁敏感对比（DSC）和动态对比增强（DCE）灌注成像已被提议作为以非侵入性方式帮助表征胶质瘤的方法。本研究旨在回顾和荟萃分析关于DSC和/或DCE灌注MRI预测异柠檬酸脱氢酶（IDH）基因型和1p/19q完整性状态准确性的证据。
在对Medline、EMBASE、科学网和考克兰图书馆进行系统文献检索后，进行了定性荟萃综合分析和定量荟萃分析。对不同灌注指标的汇总曲线下面积（AUC）数据进行荟萃分析。
在680篇论文中，12篇被纳入定性荟萃综合分析，共1384例患者。观察到，与IDH突变型胶质瘤相比，IDH野生型胶质瘤的脑血容量（CBV）、传递常数（ktrans）、血管外细胞外间隙容积分数（Ve）和血浆容积分数（Vp）值总体上显著更高。由五篇论文（共316例患者）组成的荟萃分析表明，CBV、ktrans、Ve和Vp的AUC分别为0.85（95%置信区间0.75 - 0.93）、0.81（95%置信区间0.74 - 0.89）、0.84（95%置信区间0.71 - 0.97）和0.76（95%置信区间0.61 - 0.90）。这些研究没有关于预测1p/19q完整性的确凿数据。
未来的研究应旨在基于灌注MRI数据预测1p/19q完整性。此外，应进一步研究与其他临床相关结果的相关性，包括治疗的患者分层和总生存期。
